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779627 tn?1235845890

hypersensitivity pneumonitis

I have been diagnosed with hypersensitivity pneumonitis. In 2004, I drove the length of US 95 from Maine to North Carolina. In southern Virginia, I stayed with friends in a cabin near the Great Dismal Swamp. Two days later, in Manhattan, we ate a late lunch near the WTC site. I ate my calamari. Both hands started to itch. Soon, both hands were covered with blood blisters. I had developed a fever. I was admitted to the Norwalk, CT hospital with a high fever. I became stable on IVs of Benedryl, Prednisone and an antibitoic similar to Cipro.I was sypmtom-free for four years.
In June 2008, I was cleaning black mold from the exterior of our house (no respirator). I got a fever, went to the clinic, was given a course of amoxycillin. No help. On June 21, 2008, I was admitted to the hospital, given the Cipro type antibiotic but no steroid, was on a Bipap machine and recovered. I was released That night, I was readmitted to the ICU with worse symptoms. I was given the same treatment and sent home on oral Levaquin. I had a course of Levaquin for 10 days. On the 11th day, I was admitted to the local ICU with the same symptoms. This time, my own physician put me on Prednisone.
I changed work locations in September 2008. On February 3, 2009, I went to work at 7:30 am and developed a high fever at 10:45 am. I was admitted to the hospital. My O2 sats dropped the next day to the 60s. I was placed in a coma and put on a ventilator for four days. On the same combination of drugs, I recovered and went home. I returned to work on February 23, 2009 for four hours. I went in at 10:30 am and worked until 2:30pm when I developed a high fever and was admitted to the ICMU. They pumped up the drugs and this stay only lasted two days. A condition to exists in my classroom - a leaky roof caused black mold inside the ceiling. Yesterday, the district paid for an air quality sample. Anyone is invited to respond.
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779627 tn?1235845890
Thank you for your comment. I am seeing Dr. Allen Barker at Oregon Health Sciences University on March 24. He diagnosed my wife's sarcoidosis back in the 1980s. I will share this information with him.
Since my first entry, the results of the air quality study are back concerning my classroom. I am doing paperwork in a different building at this time. The air quality sample was postive for various types of black mold in the attic, in the classroom air and in the air outside the classroom. I am most concerned with basidiospores. The technician for the school district has told the school district that the levels in the classroom air are safe. However, as I research the charateristics of these spores, I find there are over 2000 generae and they all produce the same toxins when they consume wood fibers during the dry rot process. One such toxin is mono-methyl hydrazine, a component used in rocket fuel that is highly convulsive. OSHA shows an acceptible tolerance level of .35 mg per m3. This toxin causes seizures (experienced by the last teacher who used the same room for three years), pneumonitis, and actually impacts genetic components affecting T cells. Exposure can result in death when the exposure is acute. The question to me is to what extent a 'toxin factory" might exist in the ceiling of my classroom where fungi are destroying both the wood structure and the wood-based ceilling tile. In addition, another toxin produced by basidiospore is the same one used to produce lesions in certain surgeries. One of my students has an unusual lesion in his arm pit that his doctor cannot explain. Another student was hospitalized with pneumonia during the same time period as my own most recent hospitalization. One Instructional Assistant who has worked in that classroom for 7 years, reports respiratory difficulty. One reports short term memory problems. The school district seems content with the technician's report that all is well. I have read other such reports that suggest the reported level is moderately hazardous. One characteristic of basidiospores is that they do not reproduce on laboratory materials and when tape lifts are used for harvesting samples, these spores do not stick to the tape. Yet the technician's sample contained 7 spores. I question how many more there really were.
Helpful - 1
242588 tn?1224271700
MEDICAL PROFESSIONAL
Your history is consistent with, but not diagnostic of hypersensitivity pneumonitis (HP) and the recurring aspects of your illness are a bit unusual.  There are many, many causes of HP, but I could find no reports of HP in response to black mold.  However, that would not rule out the presence of other well documented causes of HP, present in the classroom and elsewhere, along with the black mold.

Given the unusual circumstances of your illnesses, with the long symptom free intervals, other types of relapsing respiratory illness such as pulmonary sarcoidosis, vasculitis and organic dust toxic syndrome would also have to be considered in the differential diagnoses.  Fungal antigens often are implicated in HP cases associated with microbial contamination in homes.  Domestic fungal exposure associated with decaying wood and damp walls in inner city dwellings is the most common cause of HP in Australia.  These and other investigations suggest that sensitizing microbial exposures may be complex mixtures and that HP may not always be attributable to a single, well-defined antigen.

it would be important to establish both a diagnosis and specific causative factors, with as much certainty as possible, at this time.  I suggest that you consider consultation with a world expert on this disease, Cecile Rose, MD at National Jewish Health in Denver, Colorado.

Good luck.
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